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General NPI Number Information
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NPI Number | 1427622562
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Entity Type | Individual
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Provider Name | SARAH JO LIVELY ERYT-500, MSHWC
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Gender | Female
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 2308 CORNHUSKER RD
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City | BELLEVUE
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State | NE
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Zip | 68123-2410
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Country | US
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Telephone | 402-739-9176
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Fax |
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Provider Business Mailing Address
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Address Line | 2308 CORNHUSKER RD
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City | BELLEVUE
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State | NE
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Zip | 68123-2410
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Country | US
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Telephone | 402-739-9176
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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